Lumbar Mechanical Disorders
As a result of the natural wear and tear that occurs with aging, certain parts of the spine start to degenerate and wear out, as we grow older. This process makes some of the anatomic structures of the spine, the bones, intervertebral discs, ligaments, and muscles less flexible and less resistant to injury.
Spondylolysis is a defect in the lamina of the vertebrae in the pars interarticularis, usually the fourth or the fifth lumbar vertebrae in the lower (lumbar) spine. Spondylolysis may occur as a congenital defect or be the result of repetitive trauma. Some physicians believe spondylolysis may be caused by genetics, and that someone could be born with thin vertebral bones causing them to be vulnerable to the condition. Spondylolysis is common in teenage gymnasts and football players, and presents with lower back pain that is worse with strenuous exercise or activity. Radiographic findings are subtle, but bone scans or CT scans will usually detect the lesion. Activity modification, bracing, or surgical treatment may be indicated for persistent symptoms.
Spondylolysis is a prerequisite for spondylolisthesis. Spondylolisthesis occurs when spondylolysis weakens one of the vertebrae so much that the bone slips out of place.
The condition can also be caused by degenerative disc disease. If the vertebrae slip too much and begin to press on nerves, surgery may become necessary. Spondylolisthesis may also be caused by degenerative conditions that affect the vertebral joints, such as cerebral palsy.
Early treatment usually involves rest and medication. Progressive spondylolisthesis usually requires surgical treatment.
Sprains and Strains
Most acute pain in the back results from sustaining a mild strain in the back or back musculature. Sprains and strains in your lower back usually happen during a sudden and stressful injury, causing stretching or tearing of the muscles, tendons, or ligaments in your lower back. When you strain or sprain your lower back it causes a lot of stress on your spine, irritating it. If you have this condition you may also suffer from painful muscle spasms which can occur during your daily activities or at night while you’re sleeping. The pain is usually limited to five or ten days.
Sciatica is the descriptive term for when pain runs from your back or buttocks down your leg and into your foot.
It is a condition caused by either compression or trauma of the sciatic nerve. Sciatica is made worse when you cough or if someone lifts your leg up while you are lying down. Symptoms may begin abruptly or gradually, are usually irritated by movement, and often grow worse at night. Sciatica implies that there is an irritation of your nerve root in the lower part of your spine. In some instances, this could be due to a ruptured or herniated disc in your lower back.
Herniated / Ruptured Discs
A herniated (“slipped”) or ruptured disc in your back can cause each of these pain patterns. The ways in which a slipped disc causes different pain patterns and problems with your back is related to the location of the slipped disc along your spine, and also to the anatomy of your spinal column. The spinal column, or backbone, consists of 33 bones (vertebrae) and can be divided into five segments, called the cervical, thoracic, lumbar, sacral, and coccygeal sections of the spine. Each of these sections corresponds to a particular part of your body. The cervical spine is that part of the spine in your neck, the thoracic spine supports your trunk, the lumbar spine supports your lower back and abdomen, the sacrum supports your pelvis, and the coccyx is your tailbone.
Stenosis is the medical terminology for narrowing. Narrowing from degenerative disease can cause compressing of the spinal cord and/or nerves. Stenosis produces a dull, aching pain in the lower back when standing or walking. The pain usually radiates down into the buttocks and thighs, and can be relieved by stopping to rest, or by using a walker or a shopping cart in the grocery store. These symptoms usually get worse over time, and people who suffer from spinal stenosis will notice a slow decrease in their ability to walk shorter and shorter distances.
Lumbar stenosis is a natural product of aging, and the wear and tear on the spine throughout our lives. As our bodies grow older, the ligaments and bones that make up the spine grow thicker and become stiffer. The spinal canal gradually narrows, and the spinal cord is slowly compressed. The lack of space interferes with the normal function of the spinal cord and the body becomes less able to function normally.